Considerable research suggests that the expectations that individuals have about one another can cause objective changes in performance and behavior that act to "fulfill" those expectations. These interpersonal expectancy effects are common and powerful determinants of a wide variety of outcomes, and have been studied in the classroom, workplace, and numerous other settings. The proposed study is designed to shed light on how interpersonal expectancy effects occur between health care workers and elderly residents of nursing homes, a group in whom such effects may well have important clinical significance. This study is a randomized controlled trial of the effects of interpersonal expectancy in the nursing home setting. Sixty eligible consenting residents newly admitted to cooperating long term care facilities will be administered an assessment battery to meaure their performance in several domains, including affect, cognition, and activities of daily living. Half of the participating residents will be randomly assigned to a group designated as having "particularly high rehabilitation potential". Other residents will be identified as having more typical expected outcomes. Nurses and aides in the cooperating facilities will be asked to evaluate residents in both groups on a weekly basis, and will be aware of the group assignment of each resident. Outcome measures will be re-administered at three and six months using the same assessment battery used initially. We hypothesize that residents in the "high expectancy group" will in fact have objectively measurable improvements in cognition, affect, and/or self-care as compared with residents in the "typical" outcome group. A second control group will also be studied. In addition, video taped interactions between caretakers and residents in both groups will be recorded and analyzed to assess verbal and non- verbal mediation of the expectancy effects. Such work should have important implications for the training and management of health care workers in long term care settings, and for care of the elderly in general.